Information obtained from the aortic pressure waveform is affected by age, physical condition, systemic hypertension, diabetes mellitus and coronary artery disease. However, alterations in the aortic pressure waveform in patients (pts) with heart failure and left ventricular systolic dysfunction (LVSD) have not been fully described, including a description of the effect on wasted LV pressure energy and tension-time index. Non-invasive high-fidelity radial artery tonometry was used for data acquisition, and a mathematical transfer function used to generate aortic pressure waveforms (see figure
). Pulse wave analysis (PWA) of the aortic pressure waveform was used to obtain information associated with LV/vascular coupling in 23 pts age 55±9.5 yrs with LVSD (mean LV ejection fraction, 22±6%) and compared to data collected from 23 normal subjects matched for age, gender, height, weight and heart rate. Measurements obtained using PWA in heart failure pts with LVSD demonstrate decreased wasted LV energy and tension time index, consistent with poor LV mechanical performance, in addition to decreased unaugmented pressure, pulse pressure, ejection duration and augmentation index. Further standardization of these aortic pressure waveform findings in heart failure pts may allow for the clinical use of arterial PWA to non-invasively estimate LVSD.
Pulse Wave Analysis of the Aortic Pressure Waveform in Severe Left Ventricular Systolic Dysfunction